Provider Demographics
NPI:1184292518
Name:REHAB AND RECOVERY LAB
Entity type:Organization
Organization Name:REHAB AND RECOVERY LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:305-934-3506
Mailing Address - Street 1:8294 DUNDEE TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6418
Mailing Address - Country:US
Mailing Address - Phone:305-934-3506
Mailing Address - Fax:
Practice Address - Street 1:7403 MIAMI LAKES DR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6818
Practice Address - Country:US
Practice Address - Phone:305-934-3506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-13
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy